Marvin-Peek Jennifer, Sasaki Koji, Kontoyiannis Dimitrios P, Adachi Javier, Ohanian Maro, Takahashi Koichi, Issa Ghayas C, Kornblau Steven, Abbas Hussein A
Department of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
Front Med (Lausanne). 2024 Aug 1;11:1402897. doi: 10.3389/fmed.2024.1402897. eCollection 2024.
Patients with leukemia experience profound immunosuppression both from their underlying disease as well as chemotherapeutic treatment. Little is known about the prevalence and clinical presentation of nontuberculous mycobacteria (NTM) in this patient population. We identified six cases of NTM infection from 29,743 leukemia patients who had acid-fast bacilli (AFB) cultures. Four cases had bloodstream infections and five had disseminated disease, including one who presented with an unusual case of diffuse cellulitis/myositis. All patients were lymphopenic at time of diagnosis, and two patients ultimately died from their NTM infection. NTM infections are a rare, but potentially life-threatening infection in patients with leukemia. Sending AFB cultures early is important to direct appropriate antimicrobial therapy and allow for future leukemia-directed therapy.
白血病患者由于其基础疾病以及化疗治疗而经历严重的免疫抑制。对于该患者群体中非结核分枝杆菌（NTM）的患病率和临床表现知之甚少。我们从29743例进行了抗酸杆菌（AFB）培养的白血病患者中识别出6例NTM感染病例。4例发生血流感染，5例有播散性疾病，其中1例表现为罕见的弥漫性蜂窝织炎/肌炎。所有患者在诊断时均有淋巴细胞减少，2例患者最终死于NTM感染。NTM感染在白血病患者中是一种罕见但可能危及生命的感染。早期进行AFB培养对于指导适当的抗菌治疗以及后续的白血病针对性治疗很重要。
